Breastfeeding promotes healthy eating behaviour in children

Short breastfeeding duration and not breastfeeding at all are associated with the development of obesogenic eating behaviours in children and may contribute to maternal eating behaviours such as uncontrolled and emotional eating, according to a study.

“These ‘food approach’ eating behaviours may increase risk of overweight/obesity as they are associated with increased energy intake, hence the importance of research surrounding eating behaviours,” the researchers said.

Secundigravida women were enrolled to the ROLO dietary randomized controlled trial (RCT) in Dublin, Ireland, and followed up with their children up to 5 years of age. Breastfeeding exposure and duration were obtained at postnatal and infant follow-up at 2 and 6 months and 2 and 5 years.

At 5 years, the researchers measured maternal and child eating behaviours using the Three Factor Eating Questionnaire and the Child Eating Behaviour Questionnaire, respectively. They also performed regression to examine the link between breastfeeding habits and maternal eating behaviours with child eating behaviours, controlling for RCT group, maternal education level, maternal body mass index (BMI) at 5 years, childcare exposure, and child BMI centile at 5-year follow-up.

A total of 230 mother-child pairs were included in the analysis. Of these, 158 mothers had initiated breastfeeding, with a median duration of 22 weeks. Children who were never breastfed were more likely to express a desire to drink (β, –1.01; p=0.022), whereas longer breastfeeding duration correlated with lower food responsiveness (β, –1.71; p=0.003). [Eur J Clin Nutr 2021;75:670-679]

Of note, maternal uncontrolled eating positively correlated with child food responsiveness (β, 0.21; p<0.001), emotional overeating (β, 0.14; p=0.005), and emotional undereating (β, 0.14; p=0.005). In addition, maternal emotional eating seemed to contribute to child emotional overeating (β, 0.27; p<0.001) and undereating (β, 0.29; p=0.004).

In this analysis, 68 percent of mothers had initiated breastfeeding, of whom 37 percent did so for the recommended 6 months. This was higher than the World Health Organization report, which showed an average of 23 percent, as well as that reported in 2017 which stood at 58 percent. [Obes Facts 2019;12:226-243; Dublin: Institute of Public Health in Ireland 2017:1-42]

“The findings of [the current] study indicate that breastfeeding practices and positive maternal eating behaviours promote healthful child eating behaviours, known to influence child weight status,” the researchers said.

“This further elucidates the benefits of breastfeeding, and how this extends right throughout childhood. It also adds to our understanding of parental involvement in the development of child eating behaviours,” they noted.

In earlier studies, fussy eating decreased with longer breastfeeding duration. The current findings, however, did not show breastfeeding to have any association with fussy eating. [PLoS ONE 2018;13:1-12; Appetite 2017;114:374-381]

“Although in line with some previous studies … this was unexpected considering the importance of breastfeeding in developing the infants tastes and preferences for healthy foods,” the researchers said. “Such contradictory evidence requires further studies to confirm the true association.” [Ann Nutr Metab 2017;70:8-15]